MEDICARE: MRS. ASHLEY J ALLEN MS OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist	06237	MD
2	225X00000X	Occupational Therapist	0119006138	VA

General Provider Information

NPI Number	:	1659608602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY J ALLEN MS OTR/L

Provider Business Mailing Address
First Line	:	9160 BELVOIR WOODS PKWY
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-2703
Country	:	US
Telephone Number	:	703-781-2457
Fax Number	:

Provider Business Practice Location Address
First Line	:	9160 BELVOIR WOODS PKWY
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-2703
Country	:	US
Telephone Number	:	703-781-2457
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	12/10/2015

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